Functional outcome of cauda equina syndrome treated by decompression and transforaminal lumbar interbody fusion in 11 cases: a case series

The unspecific description and definition of Cauda Equina syndrome (CES) in literature gives rise to a quantum of doubts regarding its decision making and management in clinical practice. Prospective analysis of 11 cases of CES, between Jan 2015 and Sep 2017, who had been treated with Decompression and Transforaminal Lumbar Interbody Fusion, was done. The varied presentations were studied and the following parameters were assessed in the evaluation of the functional outcome of each patient: Pain (assessed by the VAS-Visual Analogue Scale), Motor status (assessed by the MRC grading), Bladder recovery (graded as per Gleave and Macfarlane) and the Oswestry Disability Index. Our analysis of the results supported the following points: Increased duration of symptoms had a negative effect on the ODI at 3 months and 1 year, the denser the neurological deficit, the worse was the ODI score at 3 months and 1 year; age>60 years had a negative effect on the ODI score at 3 months and 1 year, time to surgery since presentation had no significant effect on the overall functional outcome and ODI at 1 year, the mean VAS (Visual Analogue Scale) was drastically low at the end of 1 year with most of the patients almost free of back pain at the end of 1 year, bladder recovery was also related to the duration of symptoms and the age of the patient, as increasing age and longer duration of the deficits had a negative impact on the bladder recovery ultimately.